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INFORMATION NEEDS OF AFRICAN AMERICAN CANCER PATIENTS

非裔美国癌症患者的信息需求

基本信息

批准号：
6452966
负责人：
Alicia K Matthews
金额：
$ 3.56万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-08-01 至 2002-07-31
项目状态：
已结题

项目摘要

A study is proposed to explore information seeking, patient- provider communication, participation in treatment decision making, and emotional adjustment of a random sample of 250 African American and 250 White cancer patients and their families. Subjects will be identified from hospital tumor registries. The study partially replicates and expands a previous study exploring information seeking and treatment participation of White cancer patients (Manfredi, Czaja, Price, Ruis, and Jansizewski, 1993a). The proposed study expands previous work by exploring racial, economic, and psychosocial predictors of information seeking. African American and White samples will be matched on patient characteristics: age, gender, cancer site (breast, colon, prostate), time since diagnosis, and size of hospital where the patient was first diagnosed or treated. Data will be collected through telephone interviews of the patients to determine: 1) the information needs and information-seeking activities of the patients and their families at the time of diagnosis and sine then; 2) patient-provider communication about care decisions; 3) participation in treatment decision making; 4) the extent to which the three items above are influenced by sociopsychological characteristics of the patient, including SES (education and type of employment), type of insurance coverage, disease related factors, and coping style and resources; 5) whether the patient sought and received a second opinion or consultation or was offered or participated in a clinical trial; and 6) the patient's adjustment to the disease. The specific goals of the study are to: 1. To revise, expand and pretest the questionnaire used in the previous study of information seeking with White cancer patients (Manfredi, et al., 1993). Expansion will include adding validated psychometric instruments assessing psychosocial factors thought to affect patient information seeking and new items to assess the potential impact of race on variables such a patient-provider communication. 2. To identify and interview a random sample of 250 African American and 250 White cancer patients, stratified by cancer site (breast, prostate, colon-rectum), and matched on months since diagnosis (3-6, 7-10, 11-14), age group (less than or equal to 50, 51-64, greater than or equal to 65), gender, and size of hospital at diagnosis. 3. To analyze the above data. The main focus of the analysis will be to: a) describe the coping styles, patient-provider communication patterns, informational needs, information-seeking activities, participation in treatment decision-making, and emotional adjustment to their disease of African-American cancer patients; b) compare these characteristics with those of White cancer patients; c) explore patterns of interactions among these variables, how they are influenced by demographic and illness characteristics; and how these patterns are affected by race; d) develop a theoretical model that predicts information-seeking, participation in treatment decision making process, and emotional adjustment among individuals facing a diagnosis of cancer, based on predisposing, enabling, and reinforcing socio-psychological factors taking into consideration the effect of demographic and illness variables; and e) assess the potential effect of race and related mediating factors on the above model.

本研究旨在探讨250名非裔美国人和250名白人癌症患者及其家属的信息寻求、医患沟通、参与治疗决策和情绪调整情况。受试者将从医院肿瘤登记中确定。本研究部分复制并扩展了先前关于白人癌症患者信息寻求和治疗参与的研究（Manfredi, Czaja, Price, Ruis, and Jansizewski, 1993a）。这项提议的研究扩展了之前的工作，探索了种族、经济和社会心理因素对信息寻求的预测。非裔美国人和白人样本将根据患者特征进行匹配：年龄、性别、癌症部位（乳腺癌、结肠癌、前列腺癌）、诊断后的时间以及患者首次诊断或治疗的医院规模。通过对患者的电话访谈收集数据，以确定：1)患者及其家属在诊断时和诊断后的信息需求和信息寻求活动；2)关于护理决策的医患沟通；3)参与治疗决策；4)上述三项受患者社会心理特征的影响程度，包括SES（教育程度和就业类型）、保险范围类型、疾病相关因素、应对方式和资源；5)患者是否寻求和接受第二意见或咨询，或是否被提供或参与临床试验；6)患者对疾病的适应情况。本研究的具体目标是：1。修订、扩充和预测先前研究白人癌症患者信息寻求的问卷（Manfredi, et al, 1993）。扩展将包括增加有效的心理测量工具，评估被认为影响患者信息寻求的社会心理因素，以及评估种族对变量（如患者-提供者沟通）的潜在影响的新项目。2. 随机选取250名非裔美国人和250名白人癌症患者，根据癌症部位（乳腺癌、前列腺癌、结肠-直肠癌）分层，并在诊断后3-6个月、7-10个月、11-14个月、年龄组（小于等于50岁、51-64岁、大于等于65岁）、性别和诊断时所在医院的规模进行匹配。3. 分析上述数据。分析的主要重点将是：a)描述非裔美国癌症患者的应对方式、患者-提供者沟通模式、信息需求、信息寻求活动、参与治疗决策和对疾病的情绪调整；b)将这些特征与白人癌症患者的特征进行比较；C)探索这些变量之间的相互作用模式，以及它们如何受到人口统计学和疾病特征的影响；以及这些模式如何受到种族的影响；D)建立一个理论模型，预测面临癌症诊断的个体的信息寻求、治疗决策过程的参与和情绪调整，该模型基于易感性、激活性和强化性社会心理因素，并考虑到人口统计学和疾病变量的影响；e)评估种族和相关中介因素对上述模型的潜在影响。